Home (again!)

It wasn’t like last time.

Not even close.

This surgery, and the post-opertaive experience thus far, has been anything but the nightmare experienced back in May/June. That’s not to say that things are terrific — this was the third, fairly major intestinal surgery in under a year — but what a difference from the previous two outings.

The ‘going-under’ part was admittedly more difficult this time around: Perhaps I was hyper-aware, or maybe the memories of May/June were more present than I’d allowed myself to recognize, but the icy, pre-surgical antibiotic burned through the veins with a greater intensity than I recall it having done before. The first, failed attempt to secure the line felt as if the anaesthetist was strumming my nerve like a guitar, and even though the second vein was co-operatvive, the pain didn’t subside, and the antibiotic only irritated matters.

As the sedative crept its way through the vein, I didn’t drift off quite so easily. My ears rang with an intense, unrelenting whir. I waited for my vision to blur, but it refused, and so the whirring only grew more potent, near-overwhelming. The main OR nurse was wonderful, and she held my hand as I inhaled deeply from the mask secured to my face, pumping my lungs with pure oxygen.

I told her I was afraid, but that I didn’t know what I was afraid of.

“Just focus on the breathing,” she whispered. “It’s just the drugs. Everything will be fine.”

When I woke in recovery, I felt pain, but nothing close to the intensity of the previous surgeries. This pain was strong, yes, but not excruciating.

Back in my room, hooked up to the PCA once more, the attending nurse was reluctant to allow the free-use of the Fentanyl (rather than morphine this time), though my surgeon had a no dose limit order, because my respiration rate was low (under 10 breaths per minute), as was my pulse (mid-30s). This made for less-than-optimal pain-control for the first 12-hours post-op, but because I’d experienced far worse, I knew I could manage.

Breathing/heart function was slightly more important than being completely comfortable, I reasoned.

My blood pressure and pulse remained low even after that critical period, however, so I did my best to forgo using the PCA altogether, pressing the button only when things became too intense to manage through other means.

Though a distressing shade of purple, bordering on black, the intestine seemed to react just as well to the surgery as I had; I was able to start drinking and eating soft foods (such as yogurt) within the first 24 hours without much issue.

I was up and walking around, too, and free of any drains, catheters, etc.

Because things were going so well, my surgeon agreed to let me go home much earlier than planned.

“Only because you’re so fit,” remarked the charge nurse, with a smile.

It helps that I’m quite close to the hospital and have a direct route through the ER to the unit should problems arise, and that I’m well attuned to when things ‘aren’t right’, knowing if/when I need to go back.

Plus, I can get far better nutrition while home, and am free of the risk of contracting a hostpital-acquired infection.

“But,” my surgeon cautioned, “you need to act as if you’re in hospital for at least another week. The diet must be advanced slowly and carefully, and nothing but light walking/wandering, activity wise. You can start walking as you normally would in week two, and only in week three can you start, s-l-o-w-l-y, getting back to regular, daily activity.

Then, by the end of March, you should be more-than-ready to resume physical activity, and the recovery as a whole.

But you need to give yourself time.”

I took careful note of his instructions, agreed to follow them as meticulously as ever, and gave him a giant hug.

He smiled, squeezed me back, and told me I was his favourite patient.

And that made my heart sing, because I absolutely adore him.

And so, today I’m home, down 4 pounds since surgery, and will likely lose another few, or couple of few  (hopefully not more), before the intestinal swelling subsides enough to fully absorb what I eat, and before I’m able to take in enough nutrition to reverse the slide.

As I’ve learned, though, it cannot be forced, and I have to be patient. I don’t like the extreme fatigue and weakness that comes with lacking nutrition, nor am I particularly fond of the panic that accompanies this state. But I know it’s temporary, and soon enough, the fatigue-weakness-panic cycle will disappear, just as it did before.

Of course, it all depends on how fast – or not – the intestine rebounds. Things can’t start to get back to normal until intestinal function does, so the one-, two-, three-week guidelines are just that: guidelines.

As was the case before, my immediate focus will be on day-to-day improvements, aiming to end each day stronger, stabler, and healthier than it began; Working to keep the pain/discomfort and nausea in check, and finding ways other than physical activity to alleviate the anxiety caused by, well, inactivity.

There are sure to be hiccups along the way, as there always are, but things are off to a very promising start, and, I think, bode well for the recovery from here on in.

And thanks, as always, for accompanying me as I continue along the journey.

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